Indicators of the Addis-Kakovsky test
Last reviewed: 23.04.2024
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Reference values: erythrocytes - 0-0,5 × 10 6 / day, leukocytes - up to 2 × 10 6 / day, cylinders - up to 2 × 10 4 / day.
To calculate the number of cellular elements excreted in the urine per day, and the true ratio of the various forms of cellular elements, a Addis-Kakovski test is performed. The urine test for Addis-Kakovskiy, as well as Nechiporenko's test, is applied in clinical practice with the aim:
- detection of latent leukocyturia and hematuria and evaluation of their degrees;
- dynamic monitoring of the course of the disease;
- clarification of the prevalence of leukocyturia or hematuria.
Determining the degree of predominance of leukocyturia or hematuria is important in conducting a differential diagnosis between glomerulonephritis and pyelonephritis. With chronic pyelonephritis, the leukocyte content in the daily urine (up to 3-4 × 10 7 or more) is significantly increased and they predominate over the red blood cells. An increase in the number of leukocytes in daily urine is more often observed in the first, inflammatory stage of chronic pyelonephritis, while the development of the second, sclerotic stage of pyuria decreases. The increase in pyuria during this period indicates an exacerbation of the inflammatory process. It is always necessary to remember that the results of the study may vary due to secondary hematuria caused by urolithiasis, which is often combined with chronic pyelonephritis. In patients with glomerulonephritis, erythrocytes in the urine predominate over the leukocytes.
The Addis-Kakovskii test may have some value for assessing the functional state of the kidneys in hypertensive disease. In hypertensive disease without arteriolosclerosis of the kidneys, the sample values are normal; when the expressed arteriolosclerosis of the kidneys is attached dissociation between the white blood cells and erythrocytes is observed in the direction of the increase of the latter, the content of leukocytes remains normal.
